11/13/2017 1 Why Should an MCH Fellow/Trainee Care about Public Health? Context for the LEND Core Content Area: “Public Health Policy, Administration, and Advocacy“ November 13, 2017 Carolyn Gleason Public Health Analyst, Title V Block Grant, Region X Maternal and Child Health Bureau (MCHB) Health Resources and Services Administration (HRSA) Learning Objectives • Understanding public health foundation of the LEND Program • Understand MCH Public Health basics • Understand strategies for MCH Public Health leadership 2 FOLLOW THE MONEY! Funding and Policies are the Most Powerful Influence on any Health Care System, Program or Services (But Leadership runs a close second) Do you know where the funding and policies come from for your LEND training? 3
Transcript
11/13/2017
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Why Should an MCH Fellow/Trainee Care about Public Health?Context for the LEND Core Content Area: “Public Health Policy, Administration, and Advocacy“
November 13, 2017
Carolyn GleasonPublic Health Analyst, Title V Block Grant, Region XMaternal and Child Health Bureau (MCHB)Health Resources and Services Administration (HRSA)
Learning Objectives
• Understanding public health foundation of the LEND Program
• Understand MCH Public Health basics
• Understand strategies for MCH Public Health leadership
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FOLLOW THE MONEY!
Funding and Policies are the Most Powerful Influence on any Health Care System, Program or
Services
(But Leadership runs a close second)
Do you know where the funding and policies come from for your LEND training?
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11/13/2017
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The Big Picture: Flow of Money, Decisions, and Policies
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Whitehouse
Department of
Education
Department of
Housing & Urban
Development
Department of
Agriculture
Department of
Health & Human
Services
Department of
Labor
Executive
President
Legislative
Congress
Judicial
Supreme Court
Note: Chart shows examples of Departments; not a full representation
Authorizes
Programs
Allocates
Funding
(See next slide)
Health &
Human Services(HHS)
Administration for
Children & Families(ACF)
Welfare, Head
Start,Child Care
Centers for
Medicare & Medicaid Services
(CMS)
Publicly Funded
Insurance
Centers for
DiseaseControl &
Prevention
(CDC)
Data, Surveillance,Population-Based
Svc,
Wellness
Health Resources
And ServicesAdministration
(HRSA)
Access to Health
Care,Quality of Care,
Eliminate
Disparities
Administration for Community Living
(ACL)
AoA & Administration on
Intellectual and Developmental
Disabilities
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Note: Chart shows examples of operational divisions; not a full representation
The Big Picture: Flow of Money, Decisions, and Policies
(See next slide)
The Big Picture: Flow of Money, Decisions, and Policies
HRSA
Bureau of Primary
Health CareMaternal and Child
Health Bureau
Division of
Services
For Children
with
Special Health
Needs
Division of
Child,
Adolescent
and
Family Health
Division of
Healthy
Start and
Perinatal
Services
Division of
Maternal and
Child Health
Workforce
Development
Division of
State
and
Community
Health
Bureau of
Health
ProfessionsHIV/AIDS Bureau
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Note: Chart shows examples of Bureaus, Divisions, etc.; not a full
representation
The Big Picture: Flow of Money, Decisions, and Policies
The Big Picture: Flow of Money, Decisions, and Policies
11/13/2017
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HRSA Regional Offices
LEND is Administered by a Public Health Agency
MCHB is Primarily a Public Health Agency
Mission of Title V
Improve the health and well-being of all* the nation’s mothers, infants, children and youth…
*ALL – population and systems based
*Title V Maternal and Child Health Services Block Grant to States Program Guidancehttp://mchb.hrsa.gov/programs/titlev grants/
• Developmental Screening - Percent of children, ages 10 through 71 months, receiving a developmental screening using a parent-completed screening tool
• Medical Home - Percent of children with and without special health care needs having a medical home
• Adolescent Transition - Percent of adolescents with and without special health care needs who received services necessary to make transitions to adult health care
• Adequate Insurance - Percent of children ages 0 through 17 who are adequately insured
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Source: Title V Maternal and Child Health Services Block Grant to States Program Guidance
http://mchb.hrsa.gov/programs/titlev grants/
CYSHCN-related OUTCOME Measures
• % infants born with fetal alcohol exposure in the last 3 months of pregnancy
• Rate of infants born with neonatal abstinence syndrome
• % of eligible newborns screened for heritable disorders with on time physician notification for out of range screens who are followed up in a timely manner.
• % of children with special health care needs
• % CSHCN receiving care in a well-functioning system
• Percent of children diagnosed with an autism spectrum disorder
• Percent of children diagnosed with Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (ADD/ADHD)
• Percent of children with a mental/behavioral condition who receive treatment or counseling
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Source: Title V Maternal and Child Health Services Block Grant to States Program Guidance
http://mchb.hrsa.gov/programs/titlev grants/
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MCHB Funded Resource Centers for CSHCN
Resource Center Division Project Officer
Bright Futures DCAFH Erin Reiney
Catalyst Center DCSHCN Leticia Manning
Centers of Excellence in MCH Education, Science and Practice
DMCHWD Michelle Tissue
Got Transition DCSHCN Sarah Beth McLellan
Leadership Education in Neurodevelopmental and Related Disabilities
DCSCHN Ann Ferrero
National Center for Family/Professional Partnership
DCSCHN LaQuanta Smalley; Tigisty Zerislassie
National Center for Medical Home Improvement
DCSHCN Marie Mann
National Coordinating Center or the Regional Genetics Collaborative
DCSHCN Jill Shuger
National Maternal and Child Health Oral Health Resource Center
• AK: Develop and expand Help Me Grow Alaska as a statewide system to support providers, educators and community based service agencies in use of standardized screening tools.
• AK: Expand provider access to medical home concepts and tools through education and statewide technical assistance
• AK: Partner with statewide family leadership agencies to revise and implement Family Navigation services
• AK: Collaborate with Division of Health Care Services to improve preventative dental visit with children ages 1-20 enrolled in Medicaid program.
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*Source: Alaska State Action Plan Table on Title V Information System, https://mchb.tvisdata.hrsa.gov/Home
Public Health: : Partnerships, Systems, Policies
• ID: Develop and disseminate age-specific transition tool kits for youth with special health care needs to help empower teens and young adults to take a more active role in their health care..
• ID: Support shared medical home coordinator model at the local level to improve quality of care for CYSHCN in rural areas and supports clinic transition to the medical home model of care..
• ID: Partner with Idaho Parents Unlimited - IPUL (State's Family to Family Resource Center) to increase parent engagement, provide parent education about medical home and other relevant topics, assist with parent navigation, and provide program consultation.
• ID: CYSHCN Director participates on the state's Emergency Medical Services for Children (EMS-C) Advisory Board to represent the CYSHCN population.
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*Source: Alaska State Action Plan Table on Title V Information System, https://mchb.tvisdata.hrsa.gov/Home
Public Health: Partnerships, Systems, Policies
• WA: Improve identification of CYSHCN in Medicaid Managed Care Plans. Match the records of CYSHCN receiving Title V services with the state Medicaid database and flag records to activate comprehensive services with care coordination within their health plan..
• WA: Promote use of shared plans of care (SPOC). Use a quality improvement approach to increase the percent of children in the Maxillofacial program who have a documented SPOC that follows the Packard standards .
• WA: Prepare families and youth to be active participants in improving systems of care by supporting the infrastructure for and providing technical assistance to programs and/or organizations that provide culturally appropriate family and youth leadership training in advisory and advocacy skills and peer support.
• WA: Expand and support a centralized resource for information for families and providers of CYSHCN (including Genetics and EHDDI). Families and medical home providers of CYSHCN are able to contact a shared resource (SR) for a needed specialist, support or service.
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*Source: Alaska State Action Plan Table on Title V Information System, https://mchb.tvisdata.hrsa.gov/Home
